| NPI | 1578949764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY AUTRY Owner 678-782-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: GA LDO002203) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |